18 research outputs found
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbas Kaja M.
- Abbasi Mohammad
- Abbasi-Kangevari Mohsen
- Abbasifard Mitra
- Abbastabar Hedayat
- Abd-Allah Foad
- Abdelalim Ahmed
- Abdollahi Mohammad
- Abdollahpour Ibrahim
- Abedi Aidin
- Abedi Parisa
- Abegaz Kedir H.
- Abolhassani Hassan
- Abosetugn Akine E.
- Aboyans Victor
- Abrams Elissa M.
- Abreu Lucas G.
- Abrigo Michael R. M.
- Abu Haimed Abdulaziz K.
- Abu-Gharbieh Eman
- Abu-Raddad Laith J.
- Abualhasan Ahmed
- Abushouk Abdelrahman I.
- Acebedo Alyssa
- Ackerman Ilana N.
- Adabi Maryam
- Adair Tim
- Adamu Abdu A.
- Adebayo Oladimeji M.
- Adedeji Isaac A.
- Adekanmbi Victor
- Adelson Jaimie D.
- Adeoye Abiodun M.
- Adetokunboh Olatunji O.
- Adham Davoud
- Advani Shailesh M.
- Afarideh Mohsen
- Afshari Mahdi
- Afshin Ashkan
- Agardh Emilie E.
- Agarwal Gina
- Agasthi Pradyumna
- Agesa Kareha M.
- Aghaali Mohammad
- Aghamir Seyed M.
- Agrawal Anurag
- Ahmad Tauseef
- Ahmadi Alireza
- Ahmadi Keivan
- Ahmadi Mehdi
- Ahmadieh Hamid
- Ahmadpour Ehsan
- Ahmed Muktar B.
- Aji Budi
- Akalu Temesgen Y.
- Akinyemi Rufus O.
- Akinyemiju Tomi
- Akombi Blessing J.
- Akunna Chisom J.
- Al-Aly Ziyad
- Al-Mekhlaf Hesham M.
- Al-Raddadi Rajaa
- Alahdab Fares
- Alam Khurshid
- Alam Noore
- Alam Samiah
- Alam Tahiya
- Alanezi Fahad M.
- Alanzi Turki M.
- Albertson Samuel B.
- Alcalde-Rabanal Jacqueline E.
- Alema Niguse M.
- Alemu Biresaw W.
- Alemu Yihun M.
- Alhabib Khalid F.
- Alhassan Robert K.
- Ali Muhammad
- Ali Saqib
- Alicandro Gianfranco
- Alijanzadeh Mehran
- Alinia Cyrus
- Alipour Vahid
- Alizade Hesam
- Aljunid Syed M.
- Alla François
- Allebeck Peter
- Almadi Majid A.
- Almasi Ali
- Almasi-Hashiani Amir
- Almasri Nihad A.
- Almulhim Abdulaziz M.
- Alonso Jordi
- Altirkawi Khalid A.
- Alumran Arwa K.
- Alvis-Guzman Nelson
- Alvis-Zakzuk Nelson J.
- Amare Azmeraw T.
- Amare Bekalu
- Amini Saeed
- Amini-Rarani Mostafa
- Aminorroaya Arya
- Amiri Fatemeh
- Amit Arianna M.
- Amugsi Dickson A.
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- Ancuceanu Robert
- Anderlini Deanna
- Anderson Jason A.
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- Nnaji Chukwudi A.
- Nomura Shuhei
- Norheim Ole F.
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- Nouraei Motlagh Soraya
- Nowak Christoph
- Nsoesie Elaine
- Nunez-Samudio Virginia
- Oancea Bogdan
- Odell Christopher M.
- Ogbo Felix A. (R18978)
- Oghenetega Onome B.
- Oh In-Hwan
- Okunga Emmanuel W.
- Oladnabi Morteza
- Olagunju Andrew T.
- Olusanya Bolajoko O.
- Olusanya Jacob O.
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- Omer Omer Muktar
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- P. A. Mahesh
- Padubidri Jagadish R.
- Pakhale Smita
- Pakhare Abhijit P.
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- Palladino Raffaele
- Pana Adrian
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- Pandey Anamika
- Pangaribuan Helena U.
- Park Eun-Kee
- Park James
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- Pasupula Deepak K.
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- Patel Sangram K.
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- Pathak Ashish
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- Pilgrim Thomas
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- Pirsaheb Meghdad
- Pishgar Farhad
- Plana-Ripoll Oleguer
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- Postma Maarten J.
- Pottoo Faheem H.
- Pourjafar Hadi
- Pourmalek Farshad
- Pourmirza Kalhori Reza
- Pourshams Akram
- Poznanska Anna
- Prada Sergio I.
- Prakash Sanjay
- Prakash V.
- Prasad Narayan
- Preotescu Liliana
- Pribadi Dimas R.
- Pupillo Elisabetta
- Quazi Syed Zahiruddin
- Rabiee Mohammad
- Rabiee Navid
- Radfar Amir
- Rafiee Ata
- Rafiei Alireza
- Raggi Alberto
- Rahim Fakher
- Rahimi-Movaghar Afarin
- Rahman Mohammad H.
- Rahman Muhammad A.
- Rajabpour-Sanati Ali
- Rajati Fatemeh
- Rakovac Ivo
- Ram Pradhum
- Ramezanzadeh Kiana
- Rana Saleem M.
- Ranabhat Chhabi L.
- Ranta Annemarei
- Rao Puja C.
- Rao Sowmya J.
- Rasella Davide
- Rashedi Vahid
- Rastogi Prateek
- Rath Goura K.
- Rathi Priya
- Rawaf David L.
- Rawaf Salman
- Rawal Lal
- Rawassizadeh Reza
- Rawat Ramu
- Razo Christian
- Redford Sofia B.
- Regassa Lemma D.
- Reiner Robert C.
- Reinig Nickolas
- Reitsma Marissa B.
- Remuzzi Giuseppe
- Renjith Vishnu
- Renzaho Andre M. N. (R17978)
- Ärnlöv Johan
- Øverland Simon
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of study
Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019.
Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbastabar Hedayat
- Abd-Allah Foad
- Abdollahi Mohammad
- Abedi Aidin
- Abolhassani Hassan
- Abosetugn Akine Eshete
- Abreu Lucas Guimarães
- Abrigo Michael R. M.
- Abu Haimed Abdulaziz Khalid
- Abushouk Abdelrahman I.
- Adabi Maryam
- Adebayo Oladimeji M.
- Adekanmbi Victor
- Adelson Jaimie
- Adetokunboh Olatunji O.
- Adham Davoud
- Advani Shailesh M.
- Afshin Ashkan
- Agarwal Gina
- Agasthi Pradyumna
- Aghamir Seyed Mohammad Kazem
- Agrawal Anurag
- Ahmad Tauseef
- Akinyemi Rufus Olusola
- Al-Aly Ziyad
- Al-Mekhlafi Hesham M.
- Al-Raddadi Rajaa M.
- Alahdab Fares
- Alam Khurshid
- Albertson Samuel B.
- Alemu Yihun Mulugeta
- Alhassan Robert Kaba
- Ali Muhammad
- Ali Saqib
- Alipour Vahid
- Aljunid Syed Mohamed
- Alla François
- Almadi Majid Abdulrahman Hamad
- Almasi Ali
- Almasi-Hashiani Amir
- Almasri Nihad A.
- Almulhim Abdulaziz M.
- Alonso Jordi
- Altirkawi Khalid A.
- Alvis-Guzman Nelson
- Alvis-Zakzuk Nelson J.
- Amini Saeed
- Amini-Rarani Mostafa
- Amiri Fatemeh
- Amit Arianna Maever L.
- Amugsi Dickson A.
- Ancuceanu Robert
- Anderlini Deanna
- Andrei Catalina Liliana
- Androudi Sofia
- Ansari Fereshteh
- Ansari-Moghaddam Alireza
- Antonio Carl Abelardo T.
- Antony Catherine M.
- Antriyandarti Ernoiz
- Anvari Davood
- Anwer Razique
- Arab-Zozani Morteza
- Arabloo Jalal
- Aravkin Aleksandr Y.
- Aremu Olatunde
- Asaad Malke
- Asadi-Aliabadi Mehran
- Asadi-Pooya Ali A.
- Ashbaugh Charlie
- Athari Seyyed Shamsadin
- Atout Maha Moh'd Wahbi
- Ausloos Marcel
- Avila-Burgos Leticia
- Ayala Quintanilla Beatriz Paulina
- Ayano Getinet
- Ayanore Martin Amogre
- Aynalem Getie Lake
- Aynalem Yared Asmare
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- Azari Samad
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- Guimarães Rafael Alves
- Guled Rashid Abdi
- Gultie Teklemariam
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- Gupta Rahul
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- Hosseini Mostafa
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- Hostiuc Mihaela
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- Househ Mowafa
- Hsieh Vivian Chia-rong
- Hu Guoqing
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- Islam Sheikh Mohammed Shariful
- Islami Farhad
- Iso Hiroyasu
- Iwu Chidozie C. D.
- Iwu Chinwe Juliana
- Jaafari Jalil
- Jadidi-Niaragh Farhad
- Jafarinia Morteza
- Jahagirdar Deepa
- Jahani Mohammad Ali
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- Jakovljevic Mihajlo
- Janjani Hosna
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- Khan Maseer
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- Khater Mona M.
- Khatib Mahalaqua Nazli
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- Khubchandani Jagdish
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- Kisa Adnan
- Kissimova-Skarbek Katarzyna
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- Knight Megan
- Kocarnik Jonathan M.
- Kochhar Sonali
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- Mastrogiacomo Claudia I.
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- Tonelli Marcello
- Topor-Madry Roman
- Topouzis Fotis
- Tovani-Palone Marcos Roberto Roberto
- Tran Bach Xuan
- Travillian Ravensara
- Troeger Christopher E.
- Tudor Car Lorainne
- Uddin Riaz
- Ullah Irfan
- Umeokonkwo Chukwuma David
- Unnikrishnan Bhaskaran
- Upadhyay Era
- Uthman Olalekan A.
- Vacante Marco
- Valdez Pascual R.
- Varughese Santosh
- Vasankari Tommi Juhani
- Vasseghian Yasser
- Venketasubramanian Narayanaswamy
- Violante Francesco S.
- Vlassov Vasily
- Vollset Stein Emil
- Vongpradith Avina
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- Waheed Yasir
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- Wamai Richard G.
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- Wang Yuan-Pang
- Weintraub Robert G.
- Weiss Jordan
- Werdecker Andrea
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- Woldu Gebremariam
- Wolfe Charles D. A.
- Wu Ai-Min
- Wulf Hanson Sarah
- Xie Yang
- Xu Rixing
- Yahyazadeh Jabbari Seyed Hossein
- Yamagishi Kazumasa
- Yano Yuichiro
- Yaya Sanni
- Yazdi-Feyzabadi Vahid
- Yearwood Jamal A.
- Yeshitila Yordanos Gizachew
- Yip Paul
- Yonemoto Naohiro
- Younis Mustafa Z.
- Yousefi Zabihollah
- Yousefinezhadi Taraneh
- Yusefzadeh Hasan
- Zadey Siddhesh
- Zahirian Moghadam Telma
- Zaidi Syed Saoud
- Zaki Leila
- Zaman Sojib Bin
- Zamani Mohammad
- Zamanian Maryam
- Zandian Hamed
- Zastrozhin Mikhail Sergeevich
- Zewdie Kaleab Alemayehu
- Zhang Yunquan
- Zhao Xiu-Ju George
- Zhao Yingxi
- Zheng Peng
- Zhu Cong
- Ziapour Arash
- Zlavog Bianca S.
- Zodpey Sanjay
- Ärnlöv Johan
- Øverland Simon
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of study
Background
Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages.
Methods
Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023.
Findings
Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach 1398pooledhealthspendingpercapita(US adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia.
Interpretation
The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbas Kaja M.
- Abbasi Mohammad
- Abbasi-Kangevari Mohsen
- Abbasifard Mitra
- Abbastabar Hedayat
- Abd El Razek Hassan Magdy
- Abd El Razek Muhammed Magdy
- Abd-Allah Foad
- Abdelalim Ahmed
- Abdollahi Mohammad
- Abdollahpour Ibrahim
- Abdulkader Rizwan Suliankatchi
- Abdullah Kanaan Hamagharib
- Abedi Aidin
- Abedi Parisa
- Abegaz Kedir Hussein
- Abolhassani Hassan
- Abosetugn Akine Eshete
- Aboyans Victor
- Abrams Elissa M.
- Abreu Lucas Guimaraes
- Abrigo Michael R. M.
- Abu Haimed Abdulaziz Khalid
- Abu-Gharbieh Eman
- Abu-Raddad Laith Jamal
- Abualhasan Ahmed
- Abushouk Abdelrahman I.
- Acebedo Alyssa
- Ackerman Ilana N.
- Adabi Maryam
- Adair Tim
- Adamu Abdu A.
- Adebayo Oladimeji M.
- Adedeji Isaac Akinkunmi
- Adekanmbi Victor
- Adelson Jaimie D.
- Adeoye Abiodun Moshood
- Adetokunboh Olatunji O.
- Adham Davoud
- Advani Shailesh M.
- Afarideh Mohsen
- Afshari Mahdi
- Afshin Ashkan
- Agardh Emilie E.
- Agarwal Gina
- Agasthi Pradyumna
- Agesa Kareha M.
- Aghaali Mohammad
- Aghamir Seyed Mohammad Kazem
- Agrawal Anurag
- Ahmad Tauseef
- Ahmadi Alireza
- Ahmadi Keivan
- Ahmadi Mehdi
- Ahmadieh Hamid
- Ahmadpour Ehsan
- Ahmed Muktar Beshir
- Aji Budi
- Akalu Temesgen Yihunie
- Akinyemi Rufus Olusola
- Akinyemiju Tomi
- Akombi Blessing
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- Al-Mekhlafi Hesham M.
- Al-Raddadi Rajaa M.
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- Publication venue
- Publication date
- 01/01/2020
- Field of study
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
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- Abbas Mosapour
- Abbas Sheikhtaheri
- Abdallah M Samy
- Abdelrahman I Abushouk
- Abdiwahab Hashi
- Abdollah Mohammadian-Hafshejani
- Abdul Hafiz
- Abdulaziz Khalid Abu Haimed
- Abdulaziz M Almulhim
- Abhay Motiramji Gaidhane
- Abiyu Mekonnen Gebrehiwot
- Achala Upendra Jayatilleke
- Adam E Berman
- Addisu Melese
- Aditya Prasad Dash
- Adnan Kisa
- Adrian Otoiu
- Adrian Pana
- Agegnehu Bante Bante
- Aguilera
- Ahad Bakhtiari
- Ahamarshan Jayaraman Nagarajan
- Ahmad Daryani
- Ahmad Ghashghaee
- Ahmed I Hasaballah
- Ahmed Omar Bali
- Ai Koyanagi
- Ai-Min Wu
- Aidin Abedi
- Akine Eshete Abosetugn
- Akram Pourshams
- Akshaya Srikanth Bhagavathula
- Alan D Lopez
- Alberto Ortiz
- Alberto Raggi
- Aleksandr Y Aravkin
- Aletta Elisabeth Schutte
- Ali A Asadi-Pooya
- Ali Almasi
- Ali Bijani
- Ali H Mokdad
- Ali Rajabpour-Sanati
- Alireza Ansari-Moghaddam
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- Allemani
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- Paul Yip
- Paula Moraga
- Paulo A Lotufo
- Pawan Sirwan Faris
- Peng Jia
- Peng Zheng
- Perminder S Sachdev
- Peter Njenga Keiyoro
- Peter S Azzopardi
- Peter T N Memiah
- Phetole Walter Mahasha
- Philip B Mitchell
- Pietro Ferrara
- Platon D Lopukhov
- Pradyumna Agasthi
- Praveen Hoogar
- Priya Rathi
- Pushpendra Singh
- Quique Bassat
- Radoslaw Sierpinski
- Rafael Alves Guimarães
- Rafael Lozano
- Rafael Tabarés-Seisdedos
- Raffaele Palladino
- Rahman Shiri
- Rahmatollah Moradzadeh
- Rahul Gupta
- Rajaa M Al-Raddadi
- Rajeev Gupta
- Rajesh Sagar
- Rakhi Dandona
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- Randah R Hamadeh
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- Ratilal Lalloo
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- Ravi Mehrotra
- Ravi Prakash Jha
- Rawlance Ndejjo
- Razique Anwer
- Reed J.D. Sorensen
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- Reinhard Busse
- Reza Heidari-Soureshjani
- Reza Pourmirza Kalhori
- Reza Rawassizadeh
- Reza Shirkoohi
- Riaz Uddin
- Richard G Wamai
- Ritesh G Menezes
- Rixing Xu
- Robert Ancuceanu
- Robert G Weintraub
- Robert Kaba Alhassan
- Robert S Bernstein
- Rodrigo Sarmiento-Suárez
- Rohollah Kalhor
- Roman Topor-Madry
- Ronny Westerman
- Rosario Cárdenas
- Rufus Olusola Akinyemi
- Rupak Desai
- Ruth W Kimokoti
- Ruxandra Irina Negoi
- S. Mohammad Sajadi
- Saad M A Dahlawi
- Saeed Amini
- Saeed Shahabi
- Sagun Paudel
- Sajid Hameed
- Saleem Muhammad Rana
- Salime Goharinezhad
- Salman Rawaf
- Samad Azari
- Saman Esmaeilnejad
- Samath Dhamminda Dharmaratne
- Sameer Vali Gopalani
- Samer Hamidi
- Samuel B Albertson
- Sanjay Basu
- Sanjay Zodpey
- Sanni Yaya
- Santi Martini
- Santosh Kumar Tadakamadla
- Santosh Varughese
- Saqib Ali
- Sarah Wulf Hanson
- Sarika Chaturvedi
- Savedoff
- Savita Lasrado
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- Segun Emmanuel Ibitoye
- Sergej M Ostojic
- Sergio I Prada
- Seyed Hossein Yahyazadeh Jabbari
- Seyed M Karimi
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- Seyed Sina Naghibi Irvani
- Seyyed Shamsadin Athari
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- Shahin Soltani
- Shailesh M Advani
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- Shankar M Bakkannavar
- Shanshan Li
- Sharareh Eskandarieh
- Sharath Burugina Nagaraja
- Shaun Wen Huey Lee
- Sheikh Mohammed Shariful Islam
- Shelly Balassyano
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- Shoaib Hassan
- Shokofeh Maleki
- Shuhei Nomura
- Siamak Sabour
- Siddhesh Zadey
- Silvano Gallus
- Silvia Schiavolin
- Simachew Animen Bante
- Simon I Hay
- Simon Øverland
- Sivan Yegnanarayana Iyer Saraswathy
- Smita Pakhale
- Soewarta Kosen
- Sofia Androudi
- Soheil Hassanipour
- Sojib Bin Zaman
- Somayeh Bohlouli
- Sonali Kochhar
- Songhomitra Panda-Jonas
- Soraya Seedat
- Soraya Siabani
- Sorin Hostiuc
- Sowmya J Rao
- Spencer A Pease
- Srikanta K Banerjee
- Srinivasa Rao Rao Bolla
- Srinivasa Vittal Katikireddi
- Stanislav S Otstavnov
- Stefan Kohler
- Stefania Mondello
- Stein Emil Vollset
- Stephen S Lim
- Stevens
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- Subas Neupane
- Suraj Bhattarai
- Susan M Sawyer
- Suzanne Lyn Barker-Collo
- Syed Amir Gilani
- Syed Mohamed Aljunid
- Syed Saoud Zaidi
- Tahereh Javaheri
- Takahiro Tabuchi
- Takeshi Fukumoto
- Tamer Farag
- Tan
- Tangcharoensathien
- Tanuj Kanchan
- Tanvir M Huda
- Taraneh Yousefinezhadi
- Tariku Tesfaye Tesfaye Bekuma
- Tauseef Ahmad
- Teferi Mekonnen
- Teklehaimanot Gereziher Haile
- Teklemariam Gultie
- Telma Zahirian Moghadam
- Tessa M Pilz
- Themba G Ginindza
- Theo Vos
- Thirunavukkarasu Sathish
- Thomas Pilgrim
- Thomas R Hird
- Tiffany K Gill
- Till Winfried Bärnighausen
- Tomislav Mestrovic
- Tommi Juhani Vasankari
- Tuomo J Meretoja
- Usman Iqbal
- Vahid Alipour
- Vahid Rashedi
- Vahid Yazdi-Feyzabadi
- Valentin Yurievich Skryabin
- Valery L Feigin
- Vaman Kulkarni
- Van Charles Lansingh
- Vasily Vlassov
- Ver Bilano
- Vera Marisa Costa
- Victor Adekanmbi
- Vijay Kumar Chattu
- Vinay Nangia
- Vinod C Nayak
- Virginia Nunez-Samudio
- Vishnu Renjith
- Vivekanand Jha
- Vivian Chia-rong Hsieh
- Vladimir Andreevich Korshunov
- Vollset
- Wagstaff
- Wagstaff
- Walter Mendoza
- Weijia Fu
- Whitney L Teagle
- William M Gardner
- Wondimeneh Shibabaw Shiferaw
- Xiu-Ju George Zhao
- Xuefeng Liu
- Yahya Safari
- Yang Xie
- Yared Asmare Aynalem
- Yasir Waheed
- Yasser Vasseghian
- Yetunde O John-Akinola
- Yihun Mulugeta Alemu
- Yingxi Zhao
- Yohannes Kinfu
- Yonas Getaye Getaye Tefera
- Yordanos Gizachew Yeshitila
- Young-Eun Kim
- Young-Ho Khang
- Yousef Mohammad
- Yousef Saleh Khader
- Yuan-Pang Wang
- Yuichiro Yano
- Yuming Guo
- Yun Jin Kim
- Yunquan Zhang
- Zabihollah Yousefi
- Zahid A Butt
- Zahiruddin Quazi Syed
- Zemenu Tadesse Tessema
- Ziyad Al-Aly
- Zubair Kabir
- Zulfiqar A Bhutta
- Łukasz Szumowski
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2020
- Field of study
Background
Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages.
Methods
Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023.
Findings
Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach 1398pooledhealthspendingpercapita(US adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia.
Interpretation
The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC
Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study
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- on behalf of the COVIDSurg Collaborative
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- Zacharoulis D
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- Zouzoulas D
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- Ćoza I
- Šimko K
- Šćepanović V
- Žatecký J
- Камалов А
- Publication venue
- American Society of Clinical Oncology
- Publication date
- 01/01/2021
- Field of study
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
- Author
- Aawsaj Y
- Abadia M
- Abad‐Gurumeta A
- Abad‐Motos A
- Abassy J
- Abate E
- Abbasov A
- Abbott D
- Abbott Tom EF
- Abdalla M
- Abdeldayem H
- Abdelkabir M
- Abdelkader Salama I
- Abdelkarim M
- Abdelsamed A
- Abdulfattah F
- Abdulwahed E
- Abdur‐Rahman LO
- Abel MK
- Abelevich A
- Abiyere H
- Aboelkassem Ibrahim A
- Aboharp Hasan Z
- Abou Chaar MK
- Abreu da Silva A
- Abubakar A
- Abukhalaf SA
- Abukhalaf Sadi
- Acebes García F
- Achalandabaso Boira M
- Acher A
- Acosta Mérida MA
- Acrich E
- Adam Essa Adam ME
- Adamina M
- Adamina Michel
- Adamina Michel
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Aderombi A
- Adeyeye A
- Adeyeye A
- Adi H
- Adiamah A
- Adisa Adewale
- Afzal MF
- Agapov M
- Agarwal Arnav
- Aggarwal M
- Aghayeva A
- Agilinko J
- Agnes A
- Agostini C
- Agrawal A
- Agrawal N
- Agresta F
- Aguado López H
- Aguiar Júnior S
- Aguilar Gonzalez M
- Ahmed A
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- Ahmeidat A
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- Aimé A
- Akalin M
- Akaydin E
- Akbas A
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- Akhtar N
- Akhter Rahman MM
- Akin E
- Akkulak Murat
- Akrivou D
- Al Abdallah M
- Al ahmad F
- Al Asadi T
- Al Awwad S
- Al Ayed A
- Al Habes H
- Al Riyami S
- AL Sayed M
- Alaa S
- AlAamer O
- Aladeojebi A
- Alagoa Joao A
- Alakaloko Felix
- Alam F
- Alameer Ehab
- Alamri Alex
- Alanazi F
- Alawneh F
- Albaqami F
- Albertsmeier M
- Albertsmeier Markus
- Alcaide Matas F
- Alconchel F
- Alcázar JA
- Alderson Derek
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- Alemanno G
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- Alghamdi M
- Alghuliga A
- Alhamed A
- Alharthi M
- Alhassan N
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- Ali AA
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- Ali S
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- Alkadiki Ghadah Z
- Alkhateb S
- Allue M
- Almaadany Faraj S
- Almassaudi A
- Almeida AC
- Almeida JI
- Almeida‐Reis R
- Almezghwi H
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- Almond Max
- Alnumani T
- Alobaysi S
- Alobeed O
- Alonso de la Fuente N
- Alonso Poza A
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- Alqahtani D
- Alqannas M
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- Alsayadi M
- Alsayadi R
- Alselaim N
- Alser Osaid
- Alshaar Muhammad
- Alshahrani A
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- Alshryda Sattar
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- Altom R
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- Alurralde C
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- Alzaede S
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- Alzeerelhouseini H I. A.
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- Al‐Slaibi I
- Amaral MJ
- Amira G
- Amorim E
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- Anania G
- Anastasi A
- Andrade R
- Angamuthu N
- Angelou D
- Angenete E
- Angoso‐Clavijo M
- Annamalai S
- Annessi V
- Annicchiarico A
- Anscomb N
- Antic A
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- Antonopoulou MI
- Anula R
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- Aprile A
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- Arias‐Amézquita F
- Aribi N
- Aribi S
- Arican C
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- Arikan AE
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- Arulanantham A
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- Athanasiou A
- Atherton R
- Attia D
- Augestad Knut Magne
- Avci EK
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- Azevedo C
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- B L
- Babalola O
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- Badahdah F
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- Bagraith K
- Baguley M
- Baig M
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- Baião JM
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- Balasubramaniam D
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- Baldi C
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- Banky B
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- Barlow C
- Barlow Emma
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- Baía C
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- Beard David
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- Bigam D
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- Bozkurt E
- Bozkurt MA
- Brachini G
- Bradulskis S
- Braham H
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- Bravo Infante R
- Bravo Ana Minaya
- Breen Kerry A
- Bretherton Chris
- Brewer H
- Bristow Rob
- Brito da Silva F
- Brixton G
- Brocklehurst M
- Bromage Steve
- Brown B
- Brown C
- Brown O
- Brown SR
- Brunelli Alessandro
- Brunt A
- Bruscino A
- Buarque Igor Lima
- Bueno Cañones AD
- Buerba GA
- Bukhari SI
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- Burahee A
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- Burke Joshua
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- Bywater Edward
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- Cakmak G
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- Calikoglu F
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- Campbell W
- Canas‐Martinez A
- Cano A
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- Capolupo GT
- Capunge I
- Carabias‐Orgaz A
- Caram EL
- Carannante F
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- Charre L
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- Chaturvedi A
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- Chatzikomnitsa P
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- Chevallay M
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- Chumbinho B
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- Colquhoun Alexandra
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- Cooper Z
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- Costeira B
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- Craus‐Miguel A
- Creanga M
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- Zengin AK
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- Ângelo M
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- Çelebi F
- Çolak E
- Öfner D
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- Öğücü H
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- Ćoza I
- Ławnicka A
- Žatecký J
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2022
- Field of study
AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
Delaying surgery for patients with a previous SARS-CoV-2 infection
- Author
- A A Ali Karar
- A A Kerawala
- A A Marra
- A Abad Gurumeta
- A Abad-Motos
- A Abdelmajeed
- A Abdelrahman
- A Abdelsamed
- A Abdulkareem
- A Aboelkassem Ibrahim
- A Abouassi
- A Abreu da Silva
- A Abubakar
- A Acher
- A Aderombi
- A Adeyeye
- A Adiamah
- A Aggarwal
- A Aghayeva
- A Agnes
- A Agrawal
- A Ahmeidat
- A Aimé
- A Ajlan
- A Al-Habib
- A Al-Mohammad
- A Al-Mukhtar
- A Aladeojebi
- A Alamri
- A Alanbuki
- A Alatar
- A Alburakan
- A Alfaro-Goldaracena
- A Alhamed
- A Alhefdhi
- A Almeciga
- A Almeida
- A Alomair
- A Alonso Poza
- A Alsaif
- A Anastasi
- A Antic
- A Anzak
- A Aprile
- A Arminio
- A Arulanantham
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- A B Martins
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- A Biondi
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- A Boulton
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- A Branquinho
- A Brunelli
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- A C Almeida
- A C Deus
- A C Roslani
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- A Kolias
- A Kollàr
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- N Abbassi-Ghadi
- N Ahmadi
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- N Alam
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- Sameh Emile
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- W Yang
- Willemijn van der Plas
- Wong Mpk
- X De Sousa
- X Morales
- X S Tan
- Y Aawsaj
- Y Al-Tamimi
- Y Arkha
- Y Ayasra
- Y Bashir
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- Y Fayed
- Y H Lam
- Y Kanemitsu
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- Y Litvina
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- Y Ying
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- Z Aldayri
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- Z Krivokapic
- Z Lakkis
- Z Li
- Z M Barrett-Brown
- Z Mahasin
- Z Seymour
- Z Vilendecic
- Z Zakaria
- Á De la Hoz Rodríguez
- Á Fernández Camuñas
- É Ryan
- Ž Grubač
- А Камалов
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
Not availabl
Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)
- Author
- Abdel-Aziz Amal Kamal
- Abdelfatah Sara
- Abdellatif Mahmoud
- Abdoli Asghar
- Abel Steffen
- Abeliovich Hagai
- Abildgaard Marie H
- Abudu Yakubu Princely
- Acevedo-Arozena Abraham
- Adamopoulos Iannis E
- Adeli Khosrow
- Adolph Timon E
- Adornetto Annagrazia
- Aflaki Elma
- Afshar Elham Ghasemipour
- Agam Galila
- Agarwal Anupam
- Aggarwal Bharat B
- Agnello Maria
- Agostinis Patrizia
- Agrewala Javed N
- Agrotis Alexander
- Aguilar Patricia V
- Ahmad S Tariq
- Ahmed Zubair M
- Ahumada-Castro Ulises
- Aits Sonja
- Aizawa Shu
- Akkoc Yunus
- Akoumianaki Tonia
- Akpinar Hafize Aysin
- Al-Abd Ahmed M
- Al-Akra Lina
- Al-Bari M Abdul Alim
- Al-Gharaibeh Abeer
- Alaoui-Jamali Moulay A
- Alberti Simon
- Alcocer-Gomez Elisabet
- Alcon Soledad Porte
- Alessandri Cristiano
- Ali Muhammad
- Aliwaini Saeb
- Alizadeh Javad
- Almacellas Eugenia
- Almasan Alexandru
- Alonso Alicia
- Alonso Guillermo D
- Altan-Bonnet Nihal
- Altieri Dario C
- Alvarez Elida MC
- Alves Sara
- Alzaharna Mazen M
- Amadio Marialaura
- Amantini Consuelo
- Amaral Cristina
- Ambrosio Susanna
- Amer Amal O
- Ammanathan Veena
- An Zhenyi
- Andersen Stig U
- Andrabi Shaida A
- Andrade-Silva Magaiver
- Andres Allen M
- Angelini Sabrina
- Ann David
- Anozie Uche C
- Ansari Mohammad Y
- Antas Pedro
- Antebi Adam
- Anton Zurine
- Anwar Tahira
- Apetoh Lionel
- Apostolova Nadezda
- Araki Toshiyuki
- Araki Yasuhiro
- Arasaki Kohei
- Araujo Thais Fenz
- Araujo Wagner L
- Araya Jun
- Arden Catherine
- Arevalo Maria-Angeles
- Arguelles Sandro
- Arias Esperanza
- Arikkath Jyothi
- Arimoto Hirokazu
- Ariosa Aileen R
- Armstrong-James Darius
- Arnaune-Pelloquin Laetitia
- Aroca Angeles
- Arroyo Daniela S
- Arsov Ivica
- Artero Ruben
- Asaro Dalia Maria Lucia
- Aschner Michael
- Ashrafizadeh Milad
- Ashur-Fabian Osnat
- Atanasov Atanas G
- Au Alicia K
- Auberger Patrick
- Auner Holger W
- Aurelian Laure
- Autelli Riccardo
- Avagliano Laura
- Avalos Yenniffer
- Aveic Sanja
- Aveleira Celia Alexandra
- AvinWittenberg Tamar
- Aydin Yucel
- Ayton Scott
- Ayyadevara Srinivas
- Azzopardi Maria
- Baba Misuzu
- Backer Jonathan M
- Backues Steven K
- Bae Dong-Hun
- Bae Ok-Nam
- Bae Soo Han
- Baehrecke Eric H
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- Shen Weili
- Shen Zheni
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- Sheng Zhi
- Sheng Zu-Hang
- Shi Jianjian
- Shi Xiaobing
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- Takahashi Yoshinori
- Takats Szabolcs
- Talwar Priti
- Tam Chit
- Tam Shing Yau
- Tampellini Davide
- Tamura Atsushi
- Tan Chong Teik
- Tan Eng-King
- Tan Ya-Qin
- Tanaka Masaki
- Tanaka Motomasa
- Tang Daolin
- Tang Jingfeng
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- Thirumalaikumar VP
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- Vandenberghe Wim
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- Vannier-Santos Marcos A
- Vannini Nicola
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- Varano Gabriele
- Varela-Nieto Isabel
- Varga Mate
- Vasconcelos M Helena
- Vats Somya
- Vavvas Demetrios G
- Vega-Rubin-de-Celis Silvia
- VegaNaredo Ignacio
- Velasco Guillermo
- Velazquez Ariadna P
- Vellai Tibor
- Vellenga Edo
- Velotti Francesca
- Verdier Mireille
- Verginis Panayotis
- Vergne Isabelle
- Verkade Paul
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- Verstreken Patrik
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- Vilar Marcal
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- Villalobo Antonio
- Villarejo-Zori Beatriz
- Villarroya Francesc
- Villarroya Joan
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- Vindis Cecile
- Viret Christophe
- Viscomi Maria Teresa
- Visnjic Dora
- Vitale Ilio
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- Voitsekhovskaja Olga V
- Volonte Cinzia
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- Wang Bo
- Wang Chao-Yung
- Wang Chen
- Wang Chenran
- Wang Chenwei
- Wang Cun-Yu
- Wang Dong
- Wang Fangyang
- Wang Feng
- Wang Fengming
- Wang Guansong
- Wang Han
- Wang Hao
- Wang Hexiang
- Wang Hong-Gang
- Wang Jianrong
- Wang Jigang
- Wang Jiou
- Wang Jundong
- Wang Kui
- Wang Lianrong
- Wang Liming
- Wang Maggie Haitian
- Wang Meiqing
- Wang Nanbu
- Wang Peipei
- Wang Pengwei
- Wang Ping
- Wang Ping
- Wang Qing
- Wang Qing Jun
- Wang Qing Kenneth
- Wang Qiong A
- Wang Wen-Tao
- Wang Wuyang
- Wang Xinnan
- Wang Xuejun
- Wang Yan
- Wang Yanchang
- Wang Yanzhuang
- Wang YenYun
- Wang Yihua
- Wang Yipeng
- Wang Yu
- Wang Yuqi
- Wang Zhe
- Wang Zhenyu
- Wang Zhouguang
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- Warnsmann Verena
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- Watanabe Eizo
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- Wodrich Harald
- Woehlbier Ute
- Wollert Thomas
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- Wong Vincent Kam Wai
- Wong W Wei-Lynn
- Wu An-Guo
- Wu Chengbiao
- Wu Jian
- Wu Junfang
- Wu Kenneth K
- Wu Min
- Wu Shan-Ying
- Wu Shengzhou
- Wu Shufang
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- Xia Hongguang
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- Xia Zhengyuan
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- Xiang Jin
- Xiang Mingliang
- Xiang Wei
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- Xiao Guozhi
- Xiao Hengyi
- Xiao Hong-tao
- Xiao Jian
- Xiao Lan
- Xiao Shi
- Xiao Yin
- Xie Baoming
- Xie Chuan-Ming
- Xie Min
- Xie Yuxiang
- Xie Zhiping
- Xie Zhonglin
- Xilouri Maria
- Xu Congfeng
- Xu En
- Xu Haoxing
- Xu Jing
- Xu JinRong
- Xu Liang
- Xu Wen Wen
- Xu Xiulong
- Xue Yu
- Yakhine-Diop Sokhna MS
- Yamaguchi Masamitsu
- Yamaguchi Osamu
- Yamamoto Ai
- Yamashina Shunhei
- Yan Shengmin
- Yan Shian-Jang
- Yan Zhen
- Yanagi Yasuo
- Yang Chuanbin
- Yang Dun-Sheng
- Yang Huan
- Yang Huang-Tian
- Yang Hui
- Yang Jin-Ming
- Yang Jing
- Yang Jingyu
- Yang Ling
- Yang Liu
- Yang Ming
- Yang Pei-Ming
- Yang Qian
- Yang Seungwon
- Yang Shu
- Yang Shun-Fa
- Yang Wannian
- Yang Wei Yuan
- Yang Xiaoyong
- Yang Xuesong
- Yang Yi
- Yang Ying
- Yao Honghong
- Yao Shenggen
- Yao Xiaoqiang
- Yao Yong-Gang
- Yao Yong-Ming
- Yasui Takahiro
- Yazdankhah Meysam
- Yen Paul M
- Yi Cong
- Yin Xiao-Ming
- Yin Yanhai
- Yin Zhangyuan
- Yin Ziyi
- Ying Meidan
- Ying Zheng
- Yip Calvin K
- Yiu Stephanie Pei Tung
- Yoo Young H
- Yoshida Kiyotsugu
- Yoshii Saori R
- Yoshimori Tamotsu
- Yousefi Bahman
- Yu Boxuan
- Yu Haiyang
- Yu Jun
- Yu Jun
- Yu Li
- Yu Ming-Lung
- Yu Seong-Woon
- Yu Victor C
- Yu W Haung
- Yu Zhengping
- Yu Zhou
- Yuan Junying
- Yuan Ling-Qing
- Yuan Shilin
- Yuan Shyng-Shiou F
- Yuan Yanggang
- Yuan Zengqiang
- Yue Jianbo
- Yue Zhenyu
- Yun Jeanho
- Yung Raymond L
- Zacks David N
- Zaffagnini Gabriele
- Zambelli Vanessa O
- Zanella Isabella
- Zang Qun S
- Zanivan Sara
- Zappavigna Silvia
- Zaragoza Pilar
- Zarbalis Konstantinos S
- Zarebkohan Amir
- Zarrouk Amira
- Zeitlin Scott O
- Zeng Jialiu
- Zeng Ju-deng
- Zerovnik Eva
- Zhan Lixuan
- Zhang Bin
- Zhang Donna D
- Zhang Hanlin
- Zhang Hong
- Zhang Hong
- Zhang Honghe
- Zhang Huafeng
- Zhang Huaye
- Zhang Hui
- Zhang Hui-Ling
- Zhang Jianbin
- Zhang Jianhua
- Zhang Jing-Pu
- Zhang Kalin YB
- Zhang Leshuai W
- Zhang Lin
- Zhang Lisheng
- Zhang Lu
- Zhang Luoying
- Zhang Menghuan
- Zhang Peng
- Zhang Sheng
- Zhang Wei
- Zhang Xiangnan
- Zhang Xiao-Wei
- Zhang Xiaolei
- Zhang Xiaoyan
- Zhang Xin
- Zhang Xinxin
- Zhang Xu Dong
- Zhang Yang
- Zhang Yanjin
- Zhang Yi
- Zhang Ying-Dong
- Zhang Yingmei
- Zhang Yuan-Yuan
- Zhang Yuchen
- Zhang Zhe
- Zhang Zhengguang
- Zhang Zhibing
- Zhang Zhihai
- Zhang Zhiyong
- Zhang Zili
- Zhao Haobin
- Zhao Lei
- Zhao Shuang
- Zhao Tongbiao
- Zhao Xiao-Fan
- Zhao Ying
- Zhao Yongchao
- Zhao Yongliang
- Zhao Yuting
- Zheng Guoping
- Zheng Kai
- Zheng Ling
- Zheng Shizhong
- Zheng Xi-Long
- Zheng Yi
- Zheng Zu-Guo
- Zhivotovsky Boris
- Zhong Qing
- Zhou Ao
- Zhou Ben
- Zhou Cefan
- Zhou Gang
- Zhou Hao
- Zhou Hong
- Zhou Hongbo
- Zhou Jie
- Zhou Jing
- Zhou Jing
- Zhou Jiyong
- Zhou Kailiang
- Zhou Rongjia
- Zhou Xu-Jie
- Zhou Yanshuang
- Zhou Yinghong
- Zhou Yubin
- Zhou Zheng-Yu
- Zhou Zhou
- Zhu Binglin
- Zhu Changlian
- Zhu Guo-Qing
- Zhu Haining
- Zhu Hongxin
- Zhu Hua
- Zhu WeiGuo
- Zhu Yanping
- Zhu Yushan
- Zhuang Haixia
- Zhuang Xiaohong
- Zientara-Rytter Katarzyna
- Zimmermann Christine M
- Ziviani Elena
- Zoladek Teresa
- Zong Wei-Xing
- Zorov Dmitry B
- Zorzano Antonio
- Zou Weiping
- Zou Zhen
- Zou Zhengzhi
- Zuryn Steven
- Zwerschke Werner
- Publication venue
- 'Informa UK Limited'
- Publication date
- 01/01/2021
- Field of study
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbastabar Hedayat
- Abd-Allah Foad
- Abdollahi Mohammad
- Abedi Aidin
- Abolhassani Hassan
- Abosetugn Akine Eshete
- Abrigo Michael R M
- Abrigo Michael R.M.
- Abu Haimed Abdulaziz Khalid
- Abushouk Abdelrahman I
- Abushouk Abdelrahman I.
- Adabi Maryam
- Adebayo Oladimeji M
- Adebayo Oladimeji M.
- Adekanmbi Victor
- Adelson Jaimie
- Adetokunboh Olatunji O
- Adetokunboh Olatunji O.
- Adham Davoud
- Advani Shailesh M
- Advani Shailesh M.
- Afshin Ashkan
- Agarwal Gina
- Agasthi Pradyumna
- Aghamir Seyed Mohammad Kazem
- Agrawal Anurag
- Ahmad Tauseef
- Akinyemi Rufus Olusola
- Al-Aly Ziyad
- Al-Mekhlafi Hesham M
- Al-Mekhlafi Hesham M.
- Al-Raddadi Rajaa M
- Al-Raddadi Rajaa M.
- Alahdab Fares
- Alam Khurshid
- Albertson Samuel B
- Albertson Samuel B.
- Alemu Yihun Mulugeta
- Alhassan Robert Kaba
- Ali Muhammad
- Ali Saqib
- Alipour Vahid
- Aljunid Syed Mohamed
- Almadi Majid Abdulrahman Hamad
- Almasi Ali
- Almasi-Hashiani Amir
- Almasri Nihad A
- Almasri Nihad A.
- Almulhim Abdulaziz M
- Almulhim Abdulaziz M.
- Alonso Jordi
- Altirkawi Khalid A
- Altirkawi Khalid A.
- Alvis-Guzman Nelson
- Alvis-Zakzuk Nelson J
- Alvis-Zakzuk Nelson J.
- Amini Saeed
- Amini-Rarani Mostafa
- Amiri Fatemeh
- Amit Arianna Maever L
- Amit Arianna Maever L.
- Amugsi Dickson A
- Amugsi Dickson A.
- Ancuceanu Robert
- Anderlini Deanna
- Andrei Catalina Liliana
- Androudi Sofia
- Ansari Fereshteh
- Ansari-Moghaddam Alireza
- Antonio Carl Abelardo T
- Antonio Carl Abelardo T.
- Antony Catherine M
- Antony Catherine M.
- Antriyandarti Ernoiz
- Anvari Davood
- Anwer Razique
- Arab-Zozani Morteza
- Arabloo Jalal
- Aravkin Aleksandr Y
- Aravkin Aleksandr Y.
- Aremu Olatunde
- Asaad Malke
- Asadi-Aliabadi Mehran
- Asadi-Pooya Ali A
- Asadi-Pooya Ali A.
- Ashbaugh Charlie
- Athari Seyyed Shamsadin
- Atout Maha Moh d.Wahbi
- Atout Maha Moh'd Wahbi
- Ausloos Marcel
- Avila-Burgos Leticia
- Ayala Quintanilla Beatriz Paulina
- Ayano Getinet
- Ayanore Martin Amogre
- Aynalem Getie Lake
- Aynalem Yared Asmare
- Ayza Muluken Altaye
- Azari Samad
- Azzopardi Peter S
- Azzopardi Peter S.
- B Darshan B
- B Darshan B.
- Babaee Ebrahim
- Badiye Ashish D
- Badiye Ashish D.
- Bahrami Mohammad Amin
- Baig Atif Amin
- Bakhshaei Mohammad Hossein
- Bakhtiari Ahad
- Bakkannavar Shankar M
- Bakkannavar Shankar M.
- Balachandran Arun
- Balassyano Shelly
- Banach Maciej
- Banerjee Srikanta K
- Banik Palash Chandra
- Bante Agegnehu Bante
- Bante Simachew Animen
- Barker-Collo Suzanne Lyn
- Barrero Lope H
- Barthelemy Celine M
- Barthelemy Celine M.
- Bassat Quique
- Basu Sanjay
- Baune Bernhard T
- Bayati Mohsen
- Baye Bayisa Abdissa
- Bedi Neeraj
- Beghi Ettore
- Behzadifar Masoud
- Bekuma Tariku Tesfaye Tesfaye
- Bell Michelle L
- Bensenor Isabela M
- Berman Adam E
- Bernabe Eduardo
- Bernstein Robert S
- Bhagavathula Akshaya Srikanth
- Bhandari Dinesh
- Bhardwaj Pankaj
- Bhat Anusha Ganapati
- Bhattacharyya Krittika
- Bhattarai Suraj
- Bhutta Zulfiqar A
- Bijani Ali
- Bikbov Boris
- Bilano Ver
- Biondi Antonio
- Birihane Binyam Minuye
- Bockarie Moses John
- Bohlouli Somayeh
- Bojia Hunduma Amensisa
- Bolla Srinivasa Rao Rao
- Boloor Archith
- Brady Oliver J
- Braithwaite Dejana
- Briant Paul Svitil
- Briggs Andrew M
- Briko Nikolay Ivanovich
- Burugina Nagaraja Sharath
- Busse Reinhard
- Butt Zahid A
- Caetano dos Santos Florentino Luciano
- Cahuana-Hurtado Lucero
- Carreras Giulia
- Carrero Juan J
- Carvalho Felix
- Castaldelli-Maia Joao Mauricio
- Castelpietra Giulio
- Castro Franz
- Causey Kate
- Cederroth Christopher R
- Cercy Kelly M
- Cerin Ester
- Chandan Joht Singh
- Chang Angela Y
- Charan Jaykaran
- Chattu Vijay Kumar
- Chaturvedi Sarika
- Chin Ken Lee
- Cho Daniel Youngwhan
- Choi Jee-Young Jasmine
- Christensen Hanne
- Chu Dinh-Toi
- Chung Michael T
- Ciobanu Liliana G
- Cirillo Massimo
- Comfort Haley
- Compton Kelly
- Cortesi Paolo Angelo
- Costa Vera Marisa
- Cousin Ewerton
- Dahlawi Saad M A
- Damiani Giovanni
- Dandona Lalit
- Dandona Rakhi
- Darega Gela Jiregna
- Darwesh Aso Mohammad
- Daryani Ahmad
- Dash Aditya Prasad
- Davey Gail
- Davletov Kairat
- De Neve Jan-Walter
- Deribe Kebede
- Dervenis Nikolaos
- Desai Rupak
- Dharmaratne Samath Dhamminda
- Dhungana Govinda Prasad
- Dianatinasab Mostafa
- Dias da Silva Diana
- Diaz Daniel
- Dippenaar Ilse N
- Do Hoa Thi
- Dorostkar Fariba
- Doshmangir Leila
- Duncan Bruce B
- Duraes Andre Rodrigues
- Eagan Arielle Wilder
- Edvardsson David
- El Sayed Iman
- El Tantawi Maha
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- Zahirian Moghadam Telma
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- Zastrozhin Mikhail Sergeevich
- Zewdie Kaleab Alemayehu
- Zhang Yunquan
- Zhao Xiu-Ju George
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- Zheng Peng
- Zhu Cong
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- Zlavog Bianca S
- Zodpey Sanjay
- Publication venue
- Publication date
- 01/01/2020
- Field of study
Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach 1398pooledhealthspendingpercapita(US adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation